中国临床药理学与治疗学2017，Vol.22Issue(8)：881-886,6.
血清补体C4和C3浓度的比值在预测IgAN不良预后中的价值研究
Serum C4/C3 ratio in predicting the adverse prognosis of IgA nephropathy
摘要
Abstract
AIM:To investigate the relationship between serum complement levels and prognosis of IgA nephropathy.METHODS:Patients diagnosed through renal biopsy as primary IgA nephropathy from 2009 to 2013 in our hospital were recruited into this retrospective study.Baseline demographic,clinical laboratory examination,renal biopsy and histopathology examination,as well as the follow-up results were reviewed.The ratio of serum complement C4 to C3 (C4/C3 ratio,marked as C.ratio) was calculated.Multiple statistical methods were used to investigate the relationship between C.ratio and nephropathy prognosis.All statistics were calculated using R software and related software packages.RESULTS:A total of 206 patients were enrolled in the present study,and the median follow-up time was (37.2±6.5) months.There were 88 (42.8％) male patients.The comparison of different pathological changes of nephropathy with C.ratio showed that the C.ratio levels were significantly higher in mesangial hypercellularity,segmental fibrosis/adhesion,and interstitial fibrosis/tubular atrophy.ROC curve showed that C.ratio could effectively identify the adverse prognosis of IgA nephropathy,the area under the ROC curves was 0.735 for C.ratio,with a cut-off value of 0.25 (sensitivity:70.9％,specificity:72.2％).In addition,higher C.ratio (＞0.25) was associated with higher diastolic blood pressure,and greater proteinuria.Kaplan-meier survival analysis also confirmed that patients with higher level of C.ratio had significantly poorer nephropathy prognosis after adjusted by age,gender,blood pressure and urine protein,the Hazard Ratio was 5.1(95％CI,1.9-13.9,P=0.001).CONCLUSION:High level of serum C4 to C3 ratio was significantly associated with poor prognosis of IgA nephropathy;this could be used as a clinical prognosis predictor in IgA nephropathy patients.关键词
IgAN/补体C3/补体C4Key words
IgA nephropathy/complement C3/complement C4分类
医药卫生引用本文复制引用
周琼秀,章建娜,尤小寒,吕吟秋,陈波,张骥..血清补体C4和C3浓度的比值在预测IgAN不良预后中的价值研究[J].中国临床药理学与治疗学,2017,22(8):881-886,6.基金项目
温州市科技局(Y20130208,Y20130271) （Y20130208,Y20130271）
